How Is Hepatitis Diagnosed
The first step in diagnosing a hepatitis infection is to receive a medical exam from your doctor. The doctor will perform a physical to look for signs of the illness. All the varieties of hepatitis present with a very similar set of symptoms, which includes:
- Abdominal pain
- Nausea
- Vomiting
You may also experience jaundice or a yellowing of the skin and eyes and bowel movements that appear gray. Michael says, Fortunately, most patients are asymptomatic. If you have hepatitis B and its an active condition, meaning youre sick from it, your skin and eyes are going to have a yellow tint.
The doctor will look for these telltale signs and then order blood work to spot the viral load for the type of hepatitis and whether the infection is dormant or active. If the virus is active, you are contagious. The blood test can also determine if the infection is acute or chronic .
If the blood test confirms hepatitis, the doctor may also order an ultrasound of the liver to see if it is inflamed. The ultrasound should also show if the liver is scarred with cirrhosis. You may also have a CT or MRI to look more closely at the liver or signs of liver cancer. This is especially important if you have a family history of the disease.
Finally, in the unusual event that the imaging tests arent shedding light on the situation, the clinician may order a liver biopsy.
How Is Hepatitis C Diagnosed
In addition to taking your medical history and performing a physical exam to look for signs of liver damage, your doctor will use the results of certain blood tests to make a diagnosis.
An initial blood test screens for HCV antibodies proteins your body produces in reaction to the presence of the hepatitis virus. If the result is negative, it means youve never had HCV in your blood. If the result is positive, you were exposed to HCV at some point.
If the antibody test is positive, your doctor will conduct another blood test that looks for the RNA of HCV in your blood. There are qualitative HCV RNA tests and quantitative ones. A qualitative test determines the presence or absence of the virus in your body, while the quantitative RNA test measures the viral load, or how much virus is in the blood.
Another blood test will also be used to determine which genotype of HCV you have, as that will affect your treatment plan.
Your doctor may conduct other blood tests to assess liver damage.
Favorite Hep C Support Networks
This site gives a very detailed listing of live hep C support groups in cities across the country. Meetings are often for those undergoing treatment or people who have questions about treatment. A database that searches by ZIP code makes it simple to find a support group near you.
This online support network has about 34,000 members at latest count. People can anonymously post about all concerns related to the disease, including issues about stigma, depression, and care.
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Medical Treatment For Hepatitis A B & C
Treatment for hepatitis A, B, or C is based on which type of hepatitis is present in the bloodstream and the severity of the resulting liver damage. Depending on the results of diagnostic tests, our specialists at NYU Langone may recommend antiviral medication to stop the virus from replicating and protect your liver from further damage.
The A B Cs Of Hepatitis
Hepatitis A
The hepatitis A virus causes acute inflammation of the liver that almost always gets better on its own, although it can be more serious if you get it when you are older or if you already have liver disease. It is easily spread from person to person, in food and water, and can infect many people at once. For example, if a food handler at a restaurant is infected with hepatitis A, those who eat food prepared by that handler may be infected. Hepatitis A can be prevented by getting vaccinated.
Hepatitis B
The hepatitis B virus can be both acute and chronic and is spread through blood or other body fluids in various ways. Hepatitis B is very common in Asia and Africa and those who were born or lived in these areas should be checked for hepatitis B. Like hepatitis A, a vaccine is available to prevent HBV infection as long as you have not been previously exposed. Although chronic HBV cannot be cured, there are oral medications available to treat and control the virus.
Hepatitis C
The hepatitis C virus is almost always chronic and spreads mostly by direct blood to blood contact. Although hepatitis A and B can be prevented by vaccination, hepatitis C cannot. However, there are currently oral medications available that are able to cure Hepatitis C in 95% of all cases regardless of prior treatment history.
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What Are The Risk Factors For Getting Hepatitis B
Due to the way that hepatitis B spreads, people most at risk for getting infected include:
- Children whose mothers have been infected with hepatitis B.
- Children who have been adopted from countries with high rates of hepatitis B infection.
- People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
- People who live with or work in an institutional setting, such as prisons or group homes.
- Healthcare providers and first responders.
- People who share needles or syringes.
- People who live in close quarters with a person with chronic hepatitis B infection.
- People who are on dialysis.
Are The Daas An Actual Cure For Hep C
For starters, the DAAs are a cure. Interferon/ribavirin had a patchy track-record of helping people attain a sustained viral response which is the medical assessment for cure. Many people who previously tried interferon/ribavirin discovered, despite going through the lengthy treatment, they could still be living with hepatitis C by the end of it.
However, the hepatitis C Direct Acting Antivirals have changed that.
The new drugs work differently. Instead of trying to force the bodys immune system to kill the virus , the DAAs stop the hepatitis C virus from reproducing within liver cells. This works in over 95% of cases.
Following an SVR test, twelve weeks after the end of their DAA treatment, the vast majority of people will hear the great news that they have been cured of hepatitis C.
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Causes And Risk Factors Of Hepatitis C
Hepatitis C is transmitted when the blood of an infected person enters the body of someone who isn’t infected.
Before 1992, when widespread screening of the blood supply began, people could contract the virus through blood transfusions and organ transplants.
Today, the most common ways that transmission occurs are:
- Through the sharing of needles and syringes for intravenous drug use
- Through accidental needle injuries in healthcare settings
- During birth, if the mother has hepatitis C
Using personal care items including razors and toothbrushes that have come in contact with blood infected with HCV can put you at risk of hepatitis C.
“Hepatitis C can be easily transmitted with any blood-to-blood contact ,” Dr. Malvestutto says. “There have been cases of transmission through sharing of razors or sharing ‘straws’ to inhale drugs nasally.”
Though less common, it’s also possible to acquire a hepatitis C infection by having unprotected sex with someone who has the virus.
Given that hepatitis C is spread through blood contact, an infected mother cannot give her baby hepatitis C through breastfeeding and you cannot contract the virus through saliva .
Some factors that increase your risk of hepatitis C:
Hepatitis C has some surprising ways of showing up. For example, your birth date alone may put you at a higher risk. Healthcare professionals and members of the military are also at greater risk.
What Is Involved In A Liver Transplant
A liver transplant is considered necessary when the liver is damaged and cannot function or in some cases of liver cancer. Your liver is very important. It is responsible for many functions related to making sure that your body stays healthy and is able to digest foods.
You may be eligible for a transplant if you have chronic hepatitis B infection or some of the diseases that may result from it, including liver cancer and cirrhosis. You will have to complete testing and be evaluated before being approved for a transplant. It is likely that you will be placed on a waiting list while an appropriate organ is found.
Donated livers come from two types of donors: living and deceased. Because the liver can regenerate, it is possible to use part of a liver for transplant. The remaining sections in both the donor and the receiver will grow into livers of adequate size.
People who get liver transplants must take anti-rejection drugs for the rest of their lives. These drugs make you more susceptible to infection. However, liver transplants have become more successful over time and continue to improve.
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Does Hep A Stay With You For Life
Key facts. Hepatitis A is an inflammation of the liver that can cause mild to severe illness. The hepatitis A virus is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person. Almost everyone recovers fully from hepatitis A with a lifelong immunity.
How Do You Get Hepatitis A
The main way you get hepatitis A is when you eat or drink something that has the hep A virus in it. A lot of times this happens in a restaurant. If an infected worker there doesn’t wash their hands well after using the bathroom, and then touches food, they could pass the disease to you.
Food or drinks you buy at the supermarket can sometimes cause the disease, too. The ones most likely to get contaminated are:
- Shellfish
- Ice and water
You could catch or spread it if you’re taking care of a baby and you don’t wash your hands after changing their diaper. This can happen, for example, at a day care center.
Another way you can get hep A is when you have sex with someone who has it.
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How Is Hepatitis B Diagnosed
There are three main ways to diagnose HBV infection. They include:
- Blood tests: Tests of the blood serum shows how your bodys immune system is responding to the virus. A blood test can also tell you if you are immune to HBV.
- Abdominal ultrasound: An ultrasound uses sound waves to show the size and shape of your liver and how well the blood flows through it.
- Liver biopsy: A small sample of your liver tissue is removed though a tiny incision and sent to a lab for analysis.
The blood test that is used to diagnose hepatitis B is not a test that you get routinely during a medical visit. Often, people whove become infected first learn they have hepatitis B when they go to donate blood. Blood donations are routinely scanned for the infection.
The virus can be detected within 30 to 60 days of infection. About 70% of adults with hepatitis B develop symptoms, which tend to appear an average of 90 days after initial exposure to the virus.
Acute And Chronic Hepatitis C
Acute Hepatitis C develops several weeks after the Hepatitis C virus enters the bloodstream it becomes chronic when the virus persists for longer than six months. According to the U.S. Centers for Disease Control and Prevention, approximately 75 to 85 percent of people who become infected with this virus develop a chronic infection. Treating acute Hepatitis C drastically reduces the risk of its progression to the chronic form, which can have potentially devastating consequences.
Chronic Hepatitis C can lead to serious scarring of the liver , liver cancer and/or liver failure. The longer a person is infected with Hepatitis C, the more damage it can do to the liver. Unfortunately, the symptoms are either vague or non-existent, typically allowing the virus to flourish for years without detection. According to Camilla Graham, MD, infectious disease specialist at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School in Boston, It is called the silent epidemic because people can be infected for 30 or more years and have no idea they have it. Early detection and treatment is the best way to prevent the more serious form of Hepatitis C infection.
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Are Hepatitis B And C Preventable
Hepatitis B is a vaccine-preventable disease.
There is a three-shot vaccination series that is very effective in protecting people against the virus if theyre exposed. In the United States, all newborns are vaccinated for hepatitis B and all pregnant women are screened for hepatitis B during pregnancy. This way, mothers infected with hepatitis B can take protective steps to decrease the risk of transmission of the virus to the child.
There is no vaccine for hepatitis C.
What Should You Know About Hepatitis B Before You Travel
Hepatitis B is quite common in China and other Asian countries, where as many as 1 in 12 people have the virus, though many dont know it. Before traveling to those places, you should make sure youve been vaccinated against the virus.
In addition to getting the vaccine, you can take these additional precautions to reduce your risk of contracting the virus:
- Refrain from taking illegal drugs.
- Always use latex or polyurethane condoms during sex.
- Make sure new, sterile needles are used during all piercings, tattoos and acupuncture sessions.
- Avoid direct contact with blood and bodily fluids.
- Know the HBV status of all your sexual partners.
- Ask your doctor about possible vaccination before you travel to a place where hepatitis B is common.
A note from Cleveland Clinic
Hepatitis B is a liver disease that can cause serious damage to your health. One reason that is dangerous is that it can easily go undetected for years while damaging your liver. Talk with your healthcare provider about being tested for hepatitis B if you have any reason to believe that you were not vaccinated or if you have engaged in risky behavior. If you do test positive, follow the directions from your healthcare provider so that you can live a longer, healthier and happier life.
Last reviewed by a Cleveland Clinic medical professional on 07/09/2020.
References
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If You Notice Symptoms See A Doctor Right Away
Symptoms of hepatitis C include the following:
- Jaundice a yellowish tone to the eyes and skin
- Mild, chronic right belly pain
- Nausea
- Loss of appetite
- Fatigue
If you believe you have been exposed to hepatitis C or notice any symptoms, visit your primary care doctor as soon as possible. If you test positive for the virus, your doctor can refer you to a hepatologist to discuss your options.
“I strongly encourage all baby boomers and others who are at high risk to get tested, even if you don’t look or feel sick,” Reau says. “If you do have hepatitis C, the earlier we discover it, the more likely we can prevent it from progressing and causing more serious damage.”
It’s Different Than Hepatitis A And B
Each form of hepatitis has its own specific virus that spreads and is treated differently. “Hepatitis simply means inflammation of the liver, or that the virus has an affinity for hurting the liver,” Reau says.
- Hepatitis A is an acute, short-term infection that often does not require treatment.
- Hepatitis B hides deep in the body and, like hepatitis C, is treated in a variety of ways, from antiviral medications to liver transplants.
“The viruses are different, but all of them should be taken very seriously since they can lead to significant liver disease and even death,” she adds.
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Prevention Of Hepatitis C
There is no vaccine for hepatitis C.
The best way to avoid getting hepatitis C is to reduce your risk factors, such as by:
- Not using intravenous drugs
- Using only sterile injection equipment if you do inject drugs, and not reusing or sharing your equipment
- Not sharing personal care items that might have blood on them, including razors, toothbrushes, and nail clippers
- Safely handling needles and other sharp equipment if you are a healthcare worker
- Not getting a tattoo, body piercing, or acupuncture treatment from an unlicensed practitioner
- Practicing safe sex
Prognosis Improvement After Hbsag Clearance
These related studies provide clear recommendations that patients who achieve HBsAg clearance have favourable clinical outcomes compared to patients who achieve only HBV DNA suppression and HBeAg seroconversion. HBsAg clearance leads to biochemical, virological and liver histological improvements, and it significantly reduces the risk of HCC. However, HCC may occur after HBsAg seroclearance despite it being the ultimate treatment endpoint recommended by current guidelines. The risk factors associated with HCC include the presence of cirrhosis, male sex, and age50 years at the time of HBsAg clearance . Closer attention should be given to patients with one or more of these risk factors.
These high-risk patients should be re-examined in a timely manner even if HBsAg clearance is obtained. These results also suggest that achieving a functional cure early in the absence of cirrhosis results in a better prognosis .
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The Hepatitis B Vaccine
The hepatitis B vaccine is one of the most effective ways to prevent hepatitis B. Its usually divided into three doses, which are given over the course of six months. In many countries, infants receive their first dose of the vaccine at birth.
The Centers for Disease Control recommends that all children under the age of 19 be vaccinated if they havent already received the vaccination. Adults can also get the hepatitis B vaccine, and its generally recommended if you have an increased risk of infection due to:
- traveling to or living in a region where hepatitis B is common
- being sexually active with more than one partner
- working in a medical setting
- using intravenous drugs
If youve been exposed to the hepatitis B virus and havent been vaccinated, try to see a doctor right away. They can administer the first dose of the vaccine, though youll need to follow up to receive the remaining doses over the next few months.
They can also prescribe a medication called